Cluster headache treatment: practical guidance

Cluster headache typically involves severe attacks on one side of the head, often near the eye, with features such as tearing, eye redness, eyelid swelling, or a blocked or runny nostril on that side. Treatment planning first confirms that the pattern fits cluster headache and is not another cause of headache or facial pain. A plan may then address the attack as it happens and reduce the chance of further attacks during an active period.

Treatment safety depends on the whole person. Tell the clinician about heart or blood pressure problems, breathing conditions, pregnancy or possible pregnancy, allergies, and every prescription, non-prescription, or recreational product. These details can change which options are suitable and how they should be monitored.

Book a GP consultation if attacks are new, recurring, or disrupting daily life. Bring an attack diary showing start time, duration, side, eye and nose symptoms, restlessness, sleep impact, triggers, and treatments already tried. Ask for a step-by-step plan that states what to use at onset, what to do if it does not work, and when to contact the practice. Use medicines exactly as directed and keep them stored where they are accessible but secure. Avoid driving during severe pain or visual symptoms. Review the plan if attacks change or unwanted effects appear.

Call emergency services for a sudden, severe headache, new weakness or numbness, confusion, collapse, seizure, trouble speaking, persistent vision loss, fever with a stiff neck, or a painful red eye with reduced vision. Seek prompt clinical review when the diagnosis is uncertain, the pattern changes, pain becomes continuous, or treatment is repeatedly ineffective. Urgent assessment is safer than escalating medicines on your own.

What confirms the diagnosis in my case? What is my attack treatment and what is my preventive treatment? Are any of my medicines or health conditions relevant to safety? How will we monitor the response, and which warning signs should send me to emergency care?